title: A micro-computed tomographic study: determination of the angle between the tympanic membrane and stapes footplate in a total ossicular reconstruction prosthesis reconstruction.
abstract: OBJECTIVE
  To examine the anatomical relationship of the angles between tympanic membrane and stapes footplate and the variation of these angles among different temporal bones in order to characterize the optimal shape of total ossicular reconstruction prostheses (TORPs).
  
  
  METHODS
  Ten specimens of human temporal bones were prepared for examination with micro-computed tomography. Five of the 10 temporal bones were implanted with 3 types of TORPs before subjecting them to micro-computed tomography. The angles between tympanic membrane and stapes footplate were determined. The contact of the TORPs to these structures was assessed.
  
  
  RESULTS
  The angle between the stapes footplate and the tympanic membrane was, on average, 25.9 degrees in a plane along the transverse axis of the stapes footplate and 24.6 degrees in a plane along the longitudinal axis of the stapes footplate. Consideration of these angles in TORPs resulted in an optimal contact with the tympanic membrane and stapes footplate, especially for prostheses with a large foot.
  
  
  CONCLUSIONS
  TORPs should be adjusted in shape before insertion into the middle ear. Further developments should consider prostheses with preadjusted angles or appliances for the exact modification of the prostheses during surgery.
authors.affiliation: ENT Department, University of Regensburg, Regensburg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Herkenhoff
authors.forename: Björn
authors.initials: B
authors.lastname: Fischer
authors.forename: Otto
authors.initials: O
authors.lastname: Gleich
authors.forename: Jürgen
authors.initials: J
authors.lastname: Strutz
authors.forename: Pingling
authors.initials: P
authors.lastname: Kwok
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D011859:Radiography; D013199:Stapes / Q000000981:diagnostic imaging*; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014432:Tympanic Membrane / Q000000981:diagnostic imaging*